CLARISSA R BURCHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049236848

License Status

NOT RENEWED

Business

First Name

CLARISSA

Middle

Last Name

BURCHAM

Business Name

CLARISSA R BURCHAM

Original Issue Date

10/06/2015

Effective Date

02/16/2016

Expiration Date

03/31/2017

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

05/10/2017